A unique start to Emergency Nursing at Northwell Health
Meet Patrick Barnes, a registered nurse in the Emergency Department (ED) Nurse Fellowship at North Shore University Hospital (NSUH). Beginning his nursing career in October just before the COVID-19 pandemic, the initial months of his fellowship provided Patrick with the essential emergency nursing skills to work in a high-acuity, fast-paced emergency department- a unique start to his career.
The ED Nurse Fellowship helps new graduate and registered nurses who may be entering a new specialty gain invaluable skills before working on their own in the ED. As a fellow, Patrick spent the first 10-weeks of his career at Northwell’s Institute for Nursing with classroom education and simulation trainings to teach him the basics of working in the ED and prepare him to start working 12-hour shifts in December.
Working as a new nurse during the COVID-19 pandemic
As our emergency rooms saw a temporary increase in patient volume as the pandemic peaked in March, Patrick found strength from the experienced team around him in the ED. “Our preceptors and the other nurses in our unit have helped the nurse fellows and other new hires prepare for increased patient flow during COVID-19,” says Patrick. “Though demands in our ED would change daily, myself and the fellows I started with were able to adapt tremendously thanks to their support. We would have daily briefs and education to reinforce skills that would keep us and our patients safe.”
While his fellowship continues, the format has changed to keep our team members safe while complying with COVID-19 restrictions. Trainings and certifications are now taught through virtual platforms or while practicing social distancing in small classroom settings. Throughout the unprecedented circumstances, Patrick has never felt the guidance from Northwell and his leadership waver.
Building a future in emergency nursing at Northwell
With his fellowship now nearly over, Patrick feels prepared to start the next stages of his RN career at Northwell. “Within my first year as a nurse, Northwell has given me opportunities and training that I feel I may not have been offered elsewhere,” says Patrick. “It feels like a family once you begin to work with the team in the ED.”
Patrick’s passion for emergency nursing is the foundation for growing his career at Northwell. Working in the ED, he’s seen firsthand how our nurses have moved onto educator and management roles within the system. “It is exciting to see many of our team members move on to earn their MSN and have the support of the ED behind them,” says Patrick. “I am excited to see what the future holds at Northwell.”
Northwell Health’s Center for Emergency Medical Services (CEMS) team members often provide the first line of care to patients in the neighborhoods and communities we serve. Abdo Nahmod, assistant vice president of CEMS Operations, has helped to lead the team through both rewarding and challenging times since starting five years ago.
We sat down with Abdo to talk about CEMS initiatives on the horizon and the exciting job opportunities within the team:
How has CEMS grown over the past year?
CEMS has been progressively growing in providing quality pre-hospital care to more of the communities we serve. Over the past year we have expanded our services in Nassau and Suffolk counties and New York City, as well as added a Northwell Health Centralized Transfer Center to manage inter-facility patient transfers through the CEMS Communication Center.
We have also collaborated with Northwell’s Center for Learning and Innovation (CLI) to provide our team members with paramedic training opportunities. This is an investment in our team members, as we promote from within emergency medical technicians to paramedics, providing career opportunities for advancement and retention. This past year we also supported many team members who choose to further their clinical and post-graduate education with Northwell’s tuition reimbursement program.
How has the work of CEMS been vital to our organizations and communities during the COVID-19 pandemic?
During COVID-19, CEMS has provided emergency medical care throughout the seven counties we serve. We have seen a surge in EMS call volume for critically ill patients, providing life-saving treatments and transportation to many hospitals. CEMS had transferred over 900 COVID -19 patients throughout Northwell for continued care in March and April. We are also working with Northern Westchester Hospital’s community services team to be part of the COVID -19 testing at faith-based venues, and we will be collaborating with the FDNY for 311 and 911 telemedicine services in the near future.
What exciting initiatives are on the horizon for CEMS?
We are looking forward to the expansion of our Centralized Transfer Center, collaborating with FDNY in New York City for 311 & 911 Telemedicine services. CEMS continues to be a highly engaged workforce with a culture of teamwork and recognition. We view every challenge as an opportunity, and seek feedback while relentlessly pursuing what is best. We prize curiosity, creativity and innovation.
What careers exist within the CEMS team?
We have over a dozen job titles within CEMS such as, emergency medical technicians, paramedics, communications specialists, ambulance supply associates, flight paramedics, flight nurses, ambulance record associates, staffing schedule associates and various supervisory and leadership titles.
Our team continues to be a highly engaged workforce with a culture of teamwork and recognition. We view every challenge as an opportunity, and seek feedback while relentlessly pursuing what is best. We prize curiosity, creativity and innovation. The expectation is everyone learns, develops and becomes better. Our culture promotes self-development, ongoing education and career growth and advancement. Our reputation is everyone’s responsibility.
What career advice do you have for those looking to get into Emergency Medicine Services (EMS)?
My best advice is to volunteer in EMS in your community and see if this is something you enjoy enough to pursue as a career. EMS may be a gateway to opportunities within healthcare to other clinical and non-clinical opportunities.
Written by: Cassidy Toben, Assistant Nurse Manager, Emergency Department, Lenox Hill Hospital
Northwell Health is proud to spotlight our front line health care workers. See how Northwell clinicians – doctors and nurses – are responding and working on the front lines of the COVID-19 pandemic.Read their stories here.
Cassidy Toben, RN, finds a new niche as COVID-19 forces health care workers to shift roles
As an assistant nurse manager, I’m lucky to have the opportunity to inspire and motivate our nurses and staff, really coach them through their nursing journey. And during theCOVID-19 crisis, my role has shifted, transitioning into even more administrative responsibilities.
I’m not always in the rooms with COVID patients, and there’s a sense of guilt that comes with that. Togetherness and camaraderie are built within nurses. It’s our calling — caring for another as if we are the patients we are restoring to health. Leading my team is also a calling, one that I’ve relished during this situation.
Since COVID-19 reached our doors atLenox Hill Hospital, we’ve bundled care, limiting the number of people and trips in and out of patient rooms. What you might do in a few trips, you do all at once now.
On tough days, and there have been many, one of my nurses will need me to serve as a sounding board to vent about harrowing experiences, or to cry with them about a lost patient. Being this support system is critical to their well-being. We all share the burden and have a stake in this.
I went into nursing to save lives and to help people. But, you realize quickly that you can’t save everybody. That’s really humbling.
The scariest day during this experience came at the end of March.New York was just hitting its peakand COVID-19 patients arrived at alarming rates. One patient was talking to us and seemed pretty stable. About an hour later he coded. Everybody ran to his bedside. Then about 10 minutes after that, a patient on the other side of the emergency department coded — everyone ran to that bedside.
Then a third patient needed resuscitation.
I took a step back and, while watching every one race to the bedside, thought to myself, “Wow, the teamwork here is really inspirational.” The compassion that they showed to the patients, to each other, it eased my fears that day. We have each other’s backs and we support each other. We take care of our patients and we go home. Most of us go home alone. We don’t get to hug our parents. We don’t get to see our families. So, we’re really in this together.
But worry does come over the staff. Patients begin to remind you of your family — many times you’re acting as their family, with visitation suspended in hospitals. And then you worry about your own family, and then yourself.
My first symptoms started on March 26, a curious cough that would lead into fatigue and shortness of breath. My husband and I decided it would be safer to stay together than risk exposing anybody else in my family. Still, the thought of getting him sick caused so much anxiety that I started having nightmares. I dreamt that I got him sick and he was dying, because that’s what we were seeing each day. And any health care worker can tell you that they have that exact same fear. It’s not about me. I can handle me. But I don’t want to hurt the people I love.
After two weeks of being ill, I returned to work. I still struggle to sleep, but now it’s our patients that I worry about. It’s also really rewarding to see that our staff has risen above a lot of the challenges, remaining positive at every corner. So, even on days when I’m operating on little sleep, I come into work feeling like we can succeed. We are together and we’re going to get through it.
Luckily, the situation has improved — the volume in the emergency department has slowed. People are staying home, and we’re now on the right part of the curve. Devastation has turned into hope. We’ve lost a tremendous amount, people we know, grandparents, friends. So, we must remember those who are lost and work through each day with positivity.
In a time where it’s hard not to think about yourself and your family and worry about getting sick, people are still thinking about each other here. That is just absolutely incredible. It makes it all worthwhile, providing purpose and an unrelenting desire to help another.
That’s what nursing is truly about.
Cassidy Toben, RN, is an assistant nurse manager in Lenox Hill Hospital’s emergency department.
The Spark! Challenge: Educating high school students for future healthcare careers
The 5th annual Spark! Challenge was larger than ever with 74 Northwell teams, and 900 students participating throughout the year! Students from high schools across Long Island, Staten Island, Westchester and New York City were able to directly experience and explore the wide variety of careers available in healthcare. By connecting students, educators, and Northwell Health professionals, the Spark! Challenge is helping to reach, engage and inspire students to consider some traditional and non-traditional healthcare careers.
We talked to Northwell team members who hosted students at their sites, as well as the teachers of the visiting schools to hear how the Spark! Challenge makes an impact on our students.
Staten Island University Hospital (SIUH) – North Campus
At Staten Island University Hospital’s (SIUH) North Campus, students from St. Joseph Hill Academy participated in a mock trauma with life-like mannequins. After exciting tours of the OR and ICU, students also had the opportunity to meet and talk with the surgical team.
Jennifer Pla, St. Joseph Hill Academy teacher, was impressed by the engagement the students had with the doctors and nurses, “It gave students insight into the ongoing education that is necessary for healthcare practitioners to keep their skills sharp and improve patient care. The hands-on activities in the simulation lab allowed students to learn firsthand how difficult and technical these life-saving skills are to perform correctly.”
“The mock trauma scenario provides the ED staff with necessary simulation drills and the students love the realness of the mannequin,” says Anne Marie McDonough, senior director of Rehab Services at SIUH, “Students had an in-depth opportunity to talk with the trauma surgery staff, and they asked some fabulous questions!”
Students from Mepham High School partnered with local EMS services for a demonstration of a distracted driver with an overturned vehicle. With help from the EMS team and Syosset staff, students extracted “patients” in a hands-on scenario, then toured the emergency department and ambulance.
“We had an amazing experience that started with a simulated car accident. The fire department actually cut a ‘driver’ out of the car and followed him through the emergency department,” says Peter Steckle, Mepham High School teacher. “Students got a chance to interact with doctors and healthcare professionals to perform tasks like casting and a laparoscopic procedure. It was an experience they will never forget.”
Debra Clifford, BSN, RN, MHA, director of Patient Care Services has participated in the Spark! Challenge at Syosset Hospital for the past three years, “The Spark! Challenge provides students an opportunity through hands-on simulation to learn about careers in healthcare and has opened pathways for students to volunteer with healthcare professionals, and pursue fields that they may not have previously considered.”
Plainview Hospital’s Spark! Challenge visit gave Bellmore-Merrick CHSD students an interactive experience in the Food & Nutrition Department. From culinary arts and menu design to clinical nutrition and planning, students received an introduction to the culinary world in healthcare before ending the day with a cooking competition.
“Nothing ever becomes real until it is experienced,” says Michael DiGiovanni, CTE teacher and chef instructor at the Culinary Hospitality Applied Management Program (CHAMP) at Bellmore-Merrick CHSD, “The lessons that our students learned from the chef, cooks, and nutritionists at Northwell made their knowledge of culinary arts real and enticing. The Spark! Challenge experience demonstrated the enjoyment and sensibility of this ever-growing industry.”
Eric Sieden, director of Nutrition and Food Services at Glen Cove, Plainview and Syosset Hospitals agreed, “Our Food & Nutrition team was so excited to be able to host and share their experiences with the culinary students. Through their interactions with the cooking staff, students were able to see how Northwell is providing nutritious-restaurant quality meals to a population that deserves and appreciates it. When I was their age, the Spark! Challenge is something I would have loved and definitely benefited from.”
North Shore University Hospital
At North Shore University Hospital, students from Baldwin High School learned about all of the different career opportunities that exist within nutrition and culinary. Team members led them in a tour of the department before challenging them to cook a healthy meal.
Donna Prager, the Family and Consumer Science teacher at Baldwin High School says, “The Spark! Challenge provides an amazing opportunity to gain hands-on experience in a hospital atmosphere. Students have benefited from interacting with professionals in the culinary and nutrition fields and has helped many students solidify their anticipated career path.”
“The Spark! Challenge is always a great day for our team and the students. We all look forward each year to see the future of healthcare in these passionate students. They get so invested in the cook-off that we host each year,” says Michael Kiley, director of Nutrition and Dining Services at North Shore University Hospital, “It is so gratifying to hear a student determine their career by this program, and we have been fortunate enough to have students tell us that because of the Spark! program they made the decision to go to culinary school. What more can you ask for?”
Hear from our students on why they love the Spark! Challenge:
“The Spark! Challenge allowed me to see how medicine is progressing as new technologies are created. I now know that there are various fields throughout the medical profession which are necessary to be able to take care of patients including medical simulation technicians.”
Cayla CruzSt Joseph Hill Academy Student
“The Spark! Challenge was an eye opening experience that allowed me to expand my knowledge of the different aspects of the culinary field that I wish to pursue.”
Timothy SimsBaldwin High School Student
“The Spark! Challenge has taught me valuable lessons about not only the medical field but also teamwork. Every department comes together like a puzzle in order to create a perfect picture of healthcare. Without teams such as the sterilization unit, the scrub nurse would not be able to provide the proper instruments, which ultimately affects the surgeon. With this information, I do not only feel more prepared for the medical field, but also I am more eager to become a part of such an exciting and successful career.”
Megan PoserTottenville High School Student
“The Spark! Challenge at Staten Island University Hospital offered great exposure to students like myself who were not familiar with the field of medical simulation technology. My eyes have been opened to a new facet of medicine I would not have been introduced to otherwise and a new appreciation for professionals in this field.”
Hanna JonathanSt. Joseph Hill Academy Student
“My overall experience with Spark! has immensely impacted my future and specifically influenced my future career decision in surgery. Watching the entire OR staff contributing to the health of the patients made me realize that in the future, I would like to use my individual skills such as leadership and multitasking to contribute into saving my patients life”
Veronica RzeszutkoTottenville High School Students
“Scrubbing in and seeing a surgery was definitely a highlight of all the trips I have been to throughout the med tech program. This reinforced my motivation to be a member of the medical field and even caused me to consider a career as a CRNA. Also, touring the different departments was a great insight on how medical professionals work daily and utilize different technology. All in all I felt very privileged to be part of such a great opportunity.”
Sarah QuraishiTottenville High School Student
“Spending the day at Staten Island University Hospital was truly a great experience! From seeing the residents in action during their trauma rounds to intubating simulated patients, overall I enjoyed gaining knowledge and learning about the various specialties of the hospital.”
Gabrielle Garcia St. Joseph Hill Academy Student
“During the tour and workshop at the hospital, we were able to observe surgeries and shadow a variety of workers in the medical field and pay close attention to the responsibilities of different professions. This left a huge impact on me personally since it showed me that there’s more to the medical field than just being a doctor. There are vital roles in the medical field that most people don’t hear about and this challenge led me to discover such roles and research them. This helps me better understand the choices I make in my future in the medical field.”
Barthina GebrilTottenville High School Student
“I am extremely grateful to have been able to participate in the Spark! Challenge at Staten Island University Hospital. I was able to observe a trauma simulation conducted by the trauma team, as well as hear about different medical careers. I also got to work in the stimulation lab and practice intubating a patient, drilling for a vein, and putting a tourniquet on a patient.”
Chase CohenSt. Joseph Hill Academy Student
“I am very thankful for and enjoyed the experiences I have gained and the connections that I have made through the Spark! Challenge that I never would have made otherwise.”
Justin Brafman Baldwin High School Student
“My visit to Staten Island University Hospital was truly an eye-opening experience. Gaining insight from the different hospital perspectives, such as Simulation Technicians and Surgeons, broadened my knowledge about the many parts involved in running a medical center.”
How Assistant Director Jim Wescott is Bringing Northwell Health’s ED to Innovative Heights
Assistant Director of Emergency Medicine Service Line Jim Wescott has built his career in the ED and now he’s bringing his lively, passionate, and innovative leadership to the entire Emergency Service Line at Northwell Health. We sat down with Jim to see the ED through his eyes:
How did you get your start at Northwell Health?
I started at Southside Hospital ED in 2004 as a Staff Nurse where I stayed for 14 years. Shortly after that, Southside Hospital became a part of Northwell Health. From there, I progressed with the health system from Staff Nurse, to Charge Nurse, to Preceptor, and in 2012, I became an Assistant Nurse Manager. In 2015, I became a Nurse Manager and was integral in the expansion of the emergency department. Under my leadership, the ED progressed from an 11,000 capacity ED to 30,000. After construction, that number reached 60,000! Now, I’m Assistant Director of Emergency Medicine Service Line.
How did you know that coming to Northwell Health was the right career move for you?
I knew immediately that Southside ED was for me on my first walk through in 2004. There was a buzz and energy that was occurring in this small ED. I hadn’t even had an official interview and I was ready to jump in and start working! When Southside Hospital integrated with Northwell Health, the system did an amazing job of committing to projects and improving processes. It’s such an innovative health system! There’s just this incredible commitment to moving forward at Northwell Health and I believe it’s because the senior executive level has a passionate vision that they’ve implemented in the mid-level leadership team and disseminated throughout the entire system.
Tell us about your current role:
The Emergency Medicine service line works collaboratively with hospital executive leadership to oversee clinical operations, quality, patient experience, finance, employee investment, community benefit, teaching and research, and market growth in the system’s emergency departments. The service line drives the sharing of best practices, standardized measurement and analysis of efficiency and quality metrics, and streamlined administrative practices by partnering with site ED leadership. Additionally, the EMSL assists our sites with redesign ED workflows, coordinates with system emergency preparedness departments, and is growing the Northwell footprint through a joint venture with GoHealth Urgent Care.
We also work with sites on career development and the (this is a mouthful, sorry!) ED Service Line Clinical Leadership Development Program. It’s a terrific opportunity for our ED clinicians, ACPs, and RNs! Created in conjunction with other leaders at the service line level, program participants attend an expert-led class every month. One month might focus on emotional intelligence, another on finance, and another on business strategies. This is a unique program that’s geared toward Emergency Medicine and it’s an exciting program because you don’t traditionally get these courses in healthcare work. Our SVP and executive director, Dr. John Deangelo recognized the enormous benefit of this investment in our clinical leadership teams along the service line and through his trailblazing vision, brought it to life. The program will be kicking off its fourth class this July. As a proud alumnus of this program, I can share with you firsthand how the content of this program augmented my own career development.
How does Northwell Health encourage employees to move around within the organization?
Moving within the organization is very well received and encouraged. I was at Southside Hospital for a long time and had successful upward career mobility. There are definitely pros to progressing and growing at one site. You know the culture, you know the players, you know what to expect day-to-day- even in an ED where the landscape is unpredictable! There are also cons to staying at one site. When you take on a new role, there’s a lot to learn and I think it’s beneficial to start that new role at a different location. Each culture is different. You’ll augment your own growth by being exposed to different processes and different patterns of thinking with new leaders. Northwell Health does a great job of offering these opportunities for upward mobility throughout the system.
Have you had a great mentor at Northwell Health? What did you learn from them?
Narrowing down my mentors at Northwell Health is difficult! Senior Director of Emergency Medicine Service Line Kate O’Neill is a dynamic person. When I was a Nurse Manager, I was expanding the department to three times its size. It was a very stressful time, I could share my experiences and challenges with Kate and she was the reassuring voice I needed. Even if I knew what to do, receiving validation from her level was integral to my growth. She always had a calming presence to her and you knew she was really listening, a trait that’s a hallmark of any great leader.
There’s also Paula Fessler who has championed my career and been a mentor for years. When you look at someone like Paula, her personality and the presence she has- it’s very inspiring. She reminds you of how inclusive Northwell Health is as an organization and how they build a real culture of care from top to bottom.
Finally, there’s Jason Philip, the Administrative Director of the emergency department at Southside Hospital. I’m very passionate about leadership, coaching and mentoring. I want to teach others the lessons that I’ve learned, especially emotional intelligence- a skill that’s vital for innovative leadership. I can’t think of anyone that I’ve ever worked with who has a stronger emotional intelligence than Jason. He is ridiculously engaged in all of the many moving parts of the emergency department. You wouldn’t expect someone who’s on the MBA executive route to really get down into the weeds of clinical operations. But from his first day, Jason has fully integrated himself. He’s also the Administrative Director of the ED at Peconic Bay Hospital and he does the same thing there! I’m just amazed by his ability to listen- that’s an art that I’ve tried to perfect in my career.
What advice do you have for people just starting out in their careers?
Don’t be afraid to fail! I’ve learned so much more from trying and failing than anything I have succeeded at immediately. So to all of you starting your careers, I say this: Northwell Health is the greatest health system in the world to work for and I would go toe-to-toe with anyone who would challenge that. Shoot for the moon and don’t worry about failing while trying. In a just culture like Northwell Health, if your intentions are good and you tried your best, you won’t be berated or beaten down for it. You’ll learn from it!
Any innovative changes or growth happening in the future we should know about?
One of the numerous innovative projects our team has developed and continues to augment are real-time dashboards. Historically in health care, measuring your performance was a manual, rigorous, work exhaustive endeavor. If you were able to obtain any information it was seldom actionable as it was always a retrospective review of things you could have done better, say a few weeks, months, or even a year ago, and rarely could you benchmark these results to others. Today, our service line team utilizes real-time data with a laser focus on throughput efficacy, quality metrics, and patient experience to name a few.
By leveraging this technology our clinical leadership teams along the service line can drill down to the granular level on such things as length of stay in the ED by the hour, day, mode (walk-in or ambulance) of arrival, and truly drive sustained performance improvement by understanding the challenges and opportunities this powerful information provides our teams.
Jim Wescott is just one great example of the innovation, passion and creative thinking that is making our emergency department a trailblazer in health care. Interested in joining our incredible team in Northwell Health’s ED? RSVP here for our hiring event on August 7th!
Bringing families together through the power of compassion
Sometimes, the most heartbreaking situations grant the greatest opportunity for us to provide genuine compassionate care. This was the case recently at North Shore University Hospital where care providers across several units and two hospitals worked together to help a father and daughter reunite as a family for one last time.
A fifteen-year-old girl came into the Emergency Department at North Shore with asthma exacerbation. Due to the circumstances that surrounded her condition, she needed to be transferred to Cohen Children’s Medical Center. However, while she was still in the ED, her care providers learned that her father was a patient at that same hospital with a terminal condition.
Not knowing how much time he had left, the patient wanted to be able to visit her father before her transfer. It took teamwork from staff at both hospitals to act quickly in order to make one girl’s wish a reality.
At Northwell Health, being Truly Compassionate is more than just a figure of speech or a slogan on a wall. It is an everyday commitment. The ED Attending, RN staff and leaders at North Shore and an RN from Cohen Children’s work together to escort the girl – with telemetry monitoring and oxygen in place – to her father’s room. There the staff remained with them to maintain her care so the patient could visit her father for two hours.
Nurses proved Northwell’s values with their dedicated care, going above and beyond by remaining well past the end of their shifts to ensure a daughter shared precious time with her father. The hospital teams worked as one to bring their patients comfort and assurance during life’s most difficult times.
It was an emotional scene, and one that reminded care providers why they went into their fields in the first place. “This is an event that will stick with many of us for a long time to come,” said Marissa E. Tang, BSN, RN at North Shore University Hospital, “I personally know I will be remembering and speaking of this event myself.”
Following her time with her father, the patient was transferred to Cohen Children’s to receive the care she needed. The patient and her family showed immense gratitude that thanks to the teamwork and compassion from both staffs, a girl was able to spend time with her father who passed away the next day.
Her nurses consider it a privilege to have been able to contribute to their important final visit. Jessica Jardin, RN, BSN, CEN, and Assistant Nurse Manager at the Department of Emergency Medicine, North Shore University Hospital will never forget that day, “I know this situation resonated with my colleagues and myself, and in such a case there is no way we would have denied these two the opportunity to have such precious little time together. The collaborative team effort worked because we all wanted to see the best possible outcome of a painful situation for our patient and her family.”
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